In my experience of working for two different hospice companies, the answer to this question usually depends on the individual facility. Some facilities make it a policy that they want the on-call hospice nurse to come out and pronounce the patient, make the necessary phone calls, and support the family, and some facilities just call to notify the hospice on-call nurse but have one of their nurses do all of the above except notify the hospice medical director and DME company, which is the responsibility of the on-call hospice nurse. When I was a weekend on-call hospice nurse, it worked both ways. I went out to several facilities when one of our patients would die there, and there were other facilities that would just call to notify me that our patient died but tell me that I didn't need to come out. The hospice nurse always documents the death and how the death call was addressed, either with a visit or a phone call, and in my experience, the responsibility of discharging the patient from the system was up to the office staff the following day.